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12-20-2004, 12:37 PM

Reported December 20, 2004

Chemobrain

HOUSTON (Ivanhoe Broadcast News) -- Chemotherapy has revolutionized cancer treatment. But with the therapy comes an often overlooked side effect that researchers have dubbed "chemobrain." Here's what is and what doctors are doing to stop it.
J
anis Shea works hard to stay focused. "I'm lost," she says. "I can't say what I want to say right now. My thoughts have just left me."
Chemotherapy helped Janis beat breast cancer, but those treatments left her with memory loss and attention problems. It's a phenomenon doctors call chemobrain.

"Their memory retrieval's very unreliable, so they'll block on words in conversation or forget people's names. It's very aggravating," says Christina Meyers, Ph.D., a neuropsychologist at M. D. Anderson Cancer Center in Houston.

Janis's husband, an oncologist named Renato Lenzi, M.D., says her behavior was unusual. "She started saying things that were really out of character."

Ten years after her treatments, Janis still has trouble paying attention.
Dr. Meyers says, "I think a lot of people have that expectation that when treatment ends, the chemotherapy gets out of their body, and they should pop back to normal, and that is not the case at all."

It's not clear exactly how chemo affects the brain, but Dr. Meyers says relaxation exercises can ease symptoms. Medications like Procrit and Ritalin are also used to help patients. "It helps people focus and concentrate, and most of these patients also experience a lot of fatigue, and it helps with their stamina and fatigue as well," she says.
Janis has her own remedies. "I did a lot of journaling -- an enormous amount of reading," she says. "I read all the time. I think that I'm much, much better. However, back to normal? I don't know. I don't know what this is anymore."

But she says she's still trying to get there.

Dr. Meyers says memory and concentration problems can occur more than a year after stopping chemo treatment. However, she says not all patients on chemotherapy will experience these types of problems. More than half of people on chemotherapy develop significant chemobrain symptoms.

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to:

http://www.ivanhoe.com/newsalert/.

If you would like more information, please contact:

M.D. Anderson Information Line
(800) 392-1611

***END OF ARTICLE***

MY PERSONAL COMMENTS:

In 2002 when chemo that included Adriamycin was recommended for me, I told both my onc and my internist that I was more concerned about the question of what chemo would do to the brain than I was about whether or not it seriously affected the heart. If it is so dangerous for the heart, what would it do to the brain?

I was luckier than many, because I was stage 1 and the question of recurrence of cancer was less likely for me. But both my internist and my onc had no answer to my question and yet encouraged me to do chemo. At the time my onc, a top oncologist in his field, said that in his entire career of 30 years he had only had 5 or 6 seriously impaired patients after they did chemo. (My thought was, well.... how many that were not seriously impaired people did you have over time?)

On my own, because my health insurance would not pay for it, I had a qualified psychiatrist administer some general mental measurement tests to me so that if necessary I would have a baseline for comparison. That cost $250.

I could not afford a comparison after completing chemo and one has not been done so far, but I am having trouble not only with names but also with the kinds of simple task relationship factors that indicate I do have a problem. For example, today I went to put the blender container on the blender base. I actually tried to put it together without screwing on the circular base portion that fits into the blender base. I am very aware of these problems, but because I work at home no one else but my husband sees me and frequently he doesn't see either as he is not always with me.

Although in the past I have done things like renting an automobile and driving in the big city on my own, I am terrified now of doing that because I literally cannot recognize when I am not putting "2 + 2" together in a random situation.

I am only 53 years old and this was not part of my life prior to doing chemo at age 51. I do not believe that this is simply part of "normal aging".
I would never advise anyone to do chemo if they are at an early stage. Everyone I know thinks I have pretty much "recovered" from treatment now that I am 2 years out, even my husband. But these things happen on a daily basis and I know I have not recovered and may get worse.

Personally, I believe part of the problem is due to the lack of adequate oxygenation due to low blood counts. All of my blood counts still are slightly below normal 2 years after treatment.

It is sad that it took having an oncologist whose wife ended up dealing with it, to start looking away from chemotherapy for better ways to treat human beings who are stuck with the misery of cancer.

A.A.

12-20-2004, 12:37 PM	#1
_AlaskaAngel_ Guest Posts: n/a	Reported December 20, 2004 Chemobrain HOUSTON (Ivanhoe Broadcast News) -- Chemotherapy has revolutionized cancer treatment. But with the therapy comes an often overlooked side effect that researchers have dubbed "chemobrain." Here's what is and what doctors are doing to stop it. J anis Shea works hard to stay focused. "I'm lost," she says. "I can't say what I want to say right now. My thoughts have just left me." Chemotherapy helped Janis beat breast cancer, but those treatments left her with memory loss and attention problems. It's a phenomenon doctors call chemobrain. "Their memory retrieval's very unreliable, so they'll block on words in conversation or forget people's names. It's very aggravating," says Christina Meyers, Ph.D., a neuropsychologist at M. D. Anderson Cancer Center in Houston. Janis's husband, an oncologist named Renato Lenzi, M.D., says her behavior was unusual. "She started saying things that were really out of character." Ten years after her treatments, Janis still has trouble paying attention. Dr. Meyers says, "I think a lot of people have that expectation that when treatment ends, the chemotherapy gets out of their body, and they should pop back to normal, and that is not the case at all." It's not clear exactly how chemo affects the brain, but Dr. Meyers says relaxation exercises can ease symptoms. Medications like Procrit and Ritalin are also used to help patients. "It helps people focus and concentrate, and most of these patients also experience a lot of fatigue, and it helps with their stamina and fatigue as well," she says. Janis has her own remedies. "I did a lot of journaling -- an enormous amount of reading," she says. "I read all the time. I think that I'm much, much better. However, back to normal? I don't know. I don't know what this is anymore." But she says she's still trying to get there. Dr. Meyers says memory and concentration problems can occur more than a year after stopping chemo treatment. However, she says not all patients on chemotherapy will experience these types of problems. More than half of people on chemotherapy develop significant chemobrain symptoms. This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/. If you would like more information, please contact: M.D. Anderson Information Line (800) 392-1611 *END OF ARTICLE* MY PERSONAL COMMENTS: In 2002 when chemo that included Adriamycin was recommended for me, I told both my onc and my internist that I was more concerned about the question of what chemo would do to the brain than I was about whether or not it seriously affected the heart. If it is so dangerous for the heart, what would it do to the brain? I was luckier than many, because I was stage 1 and the question of recurrence of cancer was less likely for me. But both my internist and my onc had no answer to my question and yet encouraged me to do chemo. At the time my onc, a top oncologist in his field, said that in his entire career of 30 years he had only had 5 or 6 seriously impaired patients after they did chemo. (My thought was, well.... how many that were not seriously impaired people did you have over time?) On my own, because my health insurance would not pay for it, I had a qualified psychiatrist administer some general mental measurement tests to me so that if necessary I would have a baseline for comparison. That cost $250. I could not afford a comparison after completing chemo and one has not been done so far, but I am having trouble not only with names but also with the kinds of simple task relationship factors that indicate I do have a problem. For example, today I went to put the blender container on the blender base. I actually tried to put it together without screwing on the circular base portion that fits into the blender base. I am very aware of these problems, but because I work at home no one else but my husband sees me and frequently he doesn't see either as he is not always with me. Although in the past I have done things like renting an automobile and driving in the big city on my own, I am terrified now of doing that because I literally cannot recognize when I am not putting "2 + 2" together in a random situation. I am only 53 years old and this was not part of my life prior to doing chemo at age 51. I do not believe that this is simply part of "normal aging". I would never advise anyone to do chemo if they are at an early stage. Everyone I know thinks I have pretty much "recovered" from treatment now that I am 2 years out, even my husband. But these things happen on a daily basis and I know I have not recovered and may get worse. Personally, I believe part of the problem is due to the lack of adequate oxygenation due to low blood counts. All of my blood counts still are slightly below normal 2 years after treatment. It is sad that it took having an oncologist whose wife ended up dealing with it, to start looking away from chemotherapy for better ways to treat human beings who are stuck with the misery of cancer. A.A.